A weekly ECG / EKG review blog looking at some interesting ECG's from the world of Emergency Medicine.
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Wednesday, 6 September 2017

ECG of the Week - 4th September 2017 - Interpretation

This ECG is from a 43 yr old male with chronic severe hypertension.

Click to enlarge

﻿Rate:

132 bpm

Rhythm:

Regular

Sinus rhythm

Axis:

Normal (-33 deg)

Intervals:

PR - Normal (~180ms)

QRS - Normal (100ms)

Additional:

Voltage criteria LVH

S V1 + R V5 = 35mm

Non-voltage criteria LVH

ST Depression V5-6 with T inversion

Features suggesting additional RVH

Deep S wave V5

Biphasic high-voltage complexes V4-5

Features of left atrial abnormality

Wide and deep P waves in lead V1

Notching of p wave in lead II

Features of right atrial abnormality

Tall P wave in lead II

Interpretation:

Sinus tachycardia

Features suggestive of four chamber enlargement

Note the ECG is poorly sensitive in detecting chamber enlargement and the terminology relating to p wave morphology now refers to atrial abnormality rather than atrial enlargement. Causes of Hypertension